目的 探讨骨痛灵酊联合玻璃酸钠治疗踝关节炎的临床疗效。方法 选取2020年6月—2023年5月华北医疗健康集团峰峰总医院收治的82例踝关节炎患者，按随机数字表法将所有患者分为对照组和治疗组，每组各41例。对照组关节腔内注射玻璃酸钠注射液，2 mL/次，1次/周。治疗组在对照组治疗基础上外用骨痛灵酊，10 mL浸于敷带上，贴敷于患处，30 min/次，1次/d。两组疗程12周。观察两组的临床疗效，比较治疗前后两组踝关节肿胀评分、疼痛视觉模拟量表（VAS）评分、晨僵时间、Kofoed踝关节功能评分、AOFAS踝与后足功能评分、36项健康调查简表（SF-36）评分及血清转化生长因子-β1（TGF-β1）水平。结果 治疗后，治疗组总有效率是95.12%，较对照组的80.49%显著提高（P＜0.05）。治疗后，两组肿胀评分、疼痛VAS评分均显著降低，晨僵时间均显著缩短（P＜0.05）；治疗后，治疗组肿胀评分、疼痛VAS评分和晨僵时间改善均优于对照组（P＜0.05）。治疗后，两组Kofoed踝关节功能评分中疼痛、功能、活动度评分及其总分均显著增加（P＜0.05）；以治疗组增加更显著（P＜0.05）。治疗后，两组AOFAS踝与后足功能评分、SF-36评分均显著增加，而血清TGF-β1水平均显著降低（P＜0.05）；治疗后，治疗组AOFAS踝与后足功能评分、SF-36评分和血清TGF-β1改善优于对照组（P＜0.05）。结论 骨痛灵酊联合玻璃酸钠治疗踝关节炎在疗效及安全性方面具有较佳表现，能有效减轻患者临床症状、改善踝关节功能及提升生活质量，并下调血清TGF-β1表达而促进病情缓解。

Objective To explore the clinical efficacy of Gutongling Tincture combined with sodium hyaluronate in treatment of ankle arthritis. Methods A total of 82 patients with ankle arthritis admitted to Fengfeng General Hospital of North China Medical and Health Group from June 2020 to May 2023 were selected and divided into control group and treatment group according to random number table method, with 41 cases in each group. Patients in control group were given Sodium Hyaluronate Injection, 2 mL/time, once weekly. Patients in treatment group were given Gutongling Tincture, 10 mL was soaked on the tape and applied to the affected area, 30 min/time, once daily. Both groups were treated for 12 weeks. The clinical efficacy of two groups was observed, and the ankle joint swelling score, pain visual analogue scale (VAS) score, morning stiffness time, Kofoed ankle joint function score, AOFAS ankle and hind foot function score, 36 health survey summary (SF-36) score, and serum transforming growth factor β1 (TGF-β1) before and after treatment were compared. Results After treatment, the total effective rate of treatment group was 95.12%, which was significantly higher than that of the control group (80.49%, P < 0.05). After treatment, swelling score and pain VAS score were significantly decreased, and morning stiffness time was significantly shortened in both groups (P < 0.05). After treatment, swelling score, pain VAS score and morning stiffness time in treatment group were better than those in control group (P < 0.05). After treatment, the scores of pain, function, range of motion and total scores of Kofoed ankle joint function were significantly increased in both groups (P < 0.05). The increase was more significant in treatment group (P < 0.05). After treatment, AOFAS ankle and hind foot function scores and SF-36 scores were significantly increased, but serum TGF-β1 levels were significantly decreased in both groups (P < 0.05). After treatment, AOFAS ankle and hind foot function scores, SF-36 scores and serum TGF-β1 in treatment group were better than those in control group (P < 0.05). Conclusion Gutongling Tincture combined with sodium hyaluronate has better efficacy and safety in treatment of ankle arthritis, and can effectively reduce clinical symptoms, improve ankle joint function and improve life quality, and down-regulate the expression of TGF-β1 in serum to promote remission of disease.

R982

河北省重点研发计划自筹项目（182777245）；邯郸市科技计划项目（21422083376）